I was confronted the other day with a challenge to my belief system. I was describing to a colleague a session I conducted in a workshop with a man with AIDS suffering from peripheral neuropathy that was causing him great pain. My colleague looked at me quizzically and said, "It seems that you operate from the hypothesis that people want to get well and be free of their suffering. That is not my experience." He recounted various stories, like the woman who stops taking her medication when she is angry with her husband, or patients who have expressed their satisfaction about the care they receive from others when symptoms appear and their fear that they will not continue to receive that attention if they get well. There is a whole body of literature concerning the "secondary benefits" of illness, ways that illness gets people off the hook from advancing in life, ways of satisfying basic needs for love and belongingness.

Despite our defenses and seeming strategies of self-sabotage, I do believe that the organism wants to move towards pleasure, wholeness and joy. I have witnessed time and again the capacity of people to surprise themselves and others with great leaps of self-activation and change. The key seems to be uncovering and identifying which person that is inside of us and supporting their primacy in the dance of the selves competing for our attention! And, as with any other issue in our psyche, there are always the inevitable contradictions and conflicts at work that need to surface and be worked through.

In the second day of the workshop, we had begun with a high-energy dance that was very interactive, involving alot of touch and free movement expression. I had wanted to open the channels of energy and the group spirit before making the transition inner movement. The group laid down on their backs, giving over to the support of the floor, as I guided them through a meditation on the different places and directions of the breath (chest, ribcase, belly and whole torso). Then, they began a spinal rotation movement, the skull and pelvis rolling on the floor in opposition from side to side while maintaining awareness of the breath rhythm. The intention here is to create a "movement mantra" through repetition of simple movement. Just as a mantra keeps the mind focused in meditation, so this same principle applies in movement, to keep the mind in motion and constantly referring back to the kinesthetic, rather than the cerebral experience of self. I noticed a man (Carlo) sit up against the wall as the exploration continued. Afterwards in the group check-in, he said he stopped moving because the focus on the body brought him into contact with his pain. He was suffering from peripheral neuropathy, a painful inflammation of the nerves in the extremities of the hands, feet, and sometimes head, a side-effect of some of the AIDS drugs. He said that if he would focus on his thoughts rather than his body, the pain was tolerable. I asked him if he wanted to investigate this body symptom; he wasn’t sure at first. "I treat the pain like I treat my other problems; I put them on the side so I won’t see them," he laughed. And the aftermath of the laugh briefly lapsed into a pensive downward look, and then he said, "OK - I am ready".

I asked him to bring attention to his hands and tell me what he noticed. He stated that the pain was beginning again, growing up his arms, a certain burning sensation. "Move your hands like the pain you feel." The movement was gnarly, twisted, dense; he then began to pull on each hand, as if he was trying to take off a pair of gloves. "Speak to your hands: what do you want to say to them?" "Stay here; remain with me; don’t go away." I was a bit surprised by these statements as they sounded like relationship statements, but did not want to interpret them. "If you could translate these statements into gestures, what would they become?" His hands opened out a bit, but it appeared that he hit an edge, like the incongruence between his words and movement was confusing him. I returned to the words. "Is there a person who spontaneously comes to mind who you might be saying this to?" After no response for awhile, I stated, "There are so many affective qualities present in those statements, that one could say them with longing, anger, sadness, resignation. Try saying them in a variety of ways just to feel the different qualities in your body, to hear them in your voice". "Yes, there is alot of rage, but absolutely no sadness", he emphatically stated. The strength of the statement indicated for me the possibility of a strong boundary around experiencing his sadness. He then continued, "When you talked earlier about fire and water, I thought, my fire is what keeps me alive, I don’t want water to put that fire out, the water would overwhelm me!"(I had spoken earlier in the day how, in Chinese medicine, HIV infection is perceived as an overactive fire element that, over time, extinguishes and dries out the water element, creating an imbalance in the body’s elements. This image corresponds with the allopathic view of HIV, that it is an overactive immune response without cessation that depletes the immune system. I had suggested that the daily practice of fluid movement, like the work we had done on the floor, can help balance the fire element through the activation of the parasympathetic response of the autonomic nervous system.)

The unfolding of this story, the resistance to sadness and water, and my image of peripheral neuropathy as a metaphor for diminished and/or painful contact with the environment (for it is through our extremities that we touch and interact with others and the world) stimulated a memory of our lunch conversation the day before. He had told me about a man he fell in love with recently who had gone to Canada for a month of work. When he returned, he told him that he had met another man in Canada and that he was going back for two months to investigate this relationship. I had asked him how he felt about that and he said that he was OK with that, that he accepted this man’s freedom to do as he wished, that there was nothing he could do. I had sensed at the time a feeling that I did not quite believe him, that there was something missing from the expression that did not convince me of its veracity.

I never comment on my insights in a session, only respond to what the person has accessed on their own. I realized that a non-verbal intervention could directly address what was trying to be said below the surface rather than using words at this point. We stood facing each other, and I took his outstretched hands in my own, very lightly supporting them as his palms faced up. We stood in the silence, looking at each other. The motif I return to again and again is the question, "What do you notice now?" as a way to follow the continuous stream of change, and the shifts between sensation, image, emotion, and cognition, or what Arny Mindell, father of Process-Oriented Psychology, would call the changing of "channels"

(Arny Mindell has written extensively on Process-Oriented Psychology and body symptoms. Riding the Horse Backwards and The Dreambody in Relationships are two good sources to begin to understand his approach. )

He reported that the pain was diminishing, that there was a sense of warmth there now which was softer. His body began to sway a little from side to side; the tightness in his chest, the depth of his breathing began to change. After some time passed, he reported that the pain was gone. A look of confusion passed momentarily over his face, and then he said, " Well, the pain usually wears off after 2-3 hours after I take my medication." I smiled at him and responded," It’s hard to believe that something else may be happening here, isn’t it?" (How often do we refuse to accept a changing reality, clinging to an idea, a relationship, a formulation of identity even if this state is disproved?)

I let go of his hands and asked him to move them now. His hands stretched out, reached, closed in, opened. He smiled and stated incredulously, "The pain is gone. I can pay attention to my body without feeling pain". As he moved his hands, he kept referring to the non-reality, the absence. I kept inquiring, what is there now? As they say, nature abhors a vacuum; without a new image emerging from the void, the old reality rushes back in. Suddenly, his hands vibrated and he connected to a new image. "My hands are a huge spreading tree, reaching out around me." "Tell me more about the image...the details, the environment, the story of this tree." "It has many flowers, it is a home for many birds that sing, and the branches spread out to create shade for people when it is too hot." He appeared to be delighted with this image. This moment felt like a good place to end our work together, and I encouraged him to make a drawing of this tree for further reflection and integration.

Now, I have no illusions that Carlo will not experience the neuropathy again; the work that transpired between us was not a cure for his condition but a step on the path to healing. I believe in the principle that Alfred Tomatis, the French researcher who has developed a method around re-educating hearing and speaking, has put forward. One is not able to make a sound that one has not heard.

(Alfred Tomatis, The Conscious Ear.)

Similarly, one cannot change beliefs and concepts without experiences felt viscerally. He has now experienced the possibility that he can effect a change in his condition, whereas before, it was an inevitable effect of the drug that he had to "accept." He has "heard" through his body a new sound which has given him pleasure.

"Ask for everything-like a child asks its mother for everything, without shame. Do not stop at peace of mind or purity of heart or surrender. Demand everything. If you ask, you will receive. If you receive, you will have to bear." - Mother Meera

When is acceptance a cover-up for hopelessness, a fear of change, a distrust of our own feelings and expression? I am concerned with how current concepts of letting go and acceptance, and their somatic counterparts, relaxation practices, can actually encourage withdrawal and depression. Ideologies of relaxation and stress management can subliminally remind us of the old messages: "calm down; don’t get so upset; you are being too emotional, etc. " Relaxation methods can be counter-productive as they can promote a dissociation from our actual experience so that we become a socially-accepted "good boy/girl". The danger is that we become so detached from our feelings that we disavow their import, meaning and essential energy. In these days of industrialized healthcare, where symptoms are managed with potions, it is easy to "kill the messenger". If you are depressed, take Prozac; if you are agitated, there is Valium; if you have pain, there is Nuprin. Relaxation methods can be used in the same prescriptive fashion. If we continually sedate ourselves in response to life conditions, will we ever have the necessary motivation and energy to push the envelope? As the great abolitionist Frederick Douglass stated,

"Those who profess to favor freedom and yet deprecate agitation, are those who want crops without plowing up the ground. They want rain without thunder and lightning. They want the ocean without the awful roar of its many waters... Power concedes nothing without a demand. It never did and it never will."

Sometimes what is more appropriate than calming the impulse is to amplify it, to let the energy run its course to see what is actually there. Agitation in the self, just like body symptomsare not necessarily something to pacify, but a signal to respond to. Just because a body symptom is a side-effect of a drug does not make it an infallible reality. What in us is synergistically interacting with the chemical agent to produce the reaction? All people do not have the same side-effects, so what else is at work here? Moreover, with what attitudes do we take our medicine? As a punishment, as an annoying reminder of our differentness, as a should that we internally rebel against, or as an act of mindfulness, compassion, self-love?

I am not advocating a life of constant agitation or to suffer unnecessarily a body symptom. We all need to stabilize and cultivate a certain level of acceptance. Given life circumstances, sometimes the best that is available to us in the moment is symptom management, using whatever means possible to alleviate the immediate condition. Symptom management, like stress management, though, is very often only a temporary solution for a larger issue. Management practices can buy us some time, but are not a lasting solution.

To be in conflict, to bring forward the dueling opposites in ourselves and our relationships, is uncomfortable. Many of us spend our lives avoiding conflict at all costs due to our early experiences of non-productive and destructive conflict. Yet the avoidance of conflict is the avoidance of life, and this rigid boundary can be to the detriment of our health as well as our creativity. For all creativity is born of conflict, this clashing of opposites that demands a birth, an alchemical reaction, a new sense of self.

From the symbols and responses throughout the session, it appeared to me that Carlo’s neuropathy was a messenger, relating to his conflict between reaching out to others and expressing his need for relatedness and support, with his fear of being vulnerable, weak, and potentially rejected. On the other side of the sensation of pain was the symbol of the flowering tree, the community of life beckoning to him as an antidote to his isolation. How he embodies this symbol and applies this vision to his life is now in his hands, so to speak. This symbol of the tree appearing to him confirms for me his innate desire to get well. It reminds me how we all need support and affirmation to discover the forces within us that desire wholeness, and the surface obstacles to that unity which we need to courageously and with great faith walk through.

"If you bring forth what is within you, it will heal you. And if you do not bring forth what is within you, it will destroy you." -Gospel of St. Thomas